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Individual

JORGE LUIS CAMBO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3300 E HALIFAX CROSSING BLVD, DELTONA, FL 32725-2911
(386) 425-6100
(386) 425-6101
Mailing address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 226-4590
(386) 226-3371

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME48428
FL
207R00000X
Internal Medicine Physician
ME48428
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
061454800
FL
01
61529
BCBS
FL
Enumeration date
03/03/2006
Last updated
10/10/2018
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